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Biomedical subjects

M Weber

Publications and source records attributed to M Weber.

At least 469 records · Page 26Linked to original sources
PubMed1993

[The significance of imaging procedures for expert assessment of tendon and meniscus ruptures].

Degenerative soft tissue lesions could be proved witherto only histologically--supposed biopsy was carried out early and sufficiently. This is rarely done. Morphologic changes can be demonstrated by sonographic and MRI investigation at any time, in any region other than the lesion and especially on the contralateral side for comparison. The visualisation of degenerative changes, fresh and old ruptures of soft tissue and scarifications has a striking evidence even for medical laymen and allows--contrary to histologic examination--diagnostic assessment in time. Thus misinterpretations by physician, patient and insurance-company can be avoided. The phasical development of soft tissue disease (necrobiosis, degeneration, defect, reparation) can be demonstrated and related to conventional x-ray findings. The visualisation of a chronological process emphasizes the importance of the patient's history, clinical and x-ray signs and thus improves diagnostic accuracy by combination of all diagnostic means. The false negative result of conventional x-rays can be avoided as well as the misinterpretation or simplification of complex medical legal problems.

Diagnostic Imaging↗
PubMed1993

[Ambulatory surgery and anesthesia. An inquiry study].

Patients who had undergone surgical procedures as out-patients in either general or local anaesthesia were asked to complete a questionnaire with the aim of evaluating how they had experienced their operation, especially with respect to treatment and prevention of postoperative pain. Over a 12 month period, 851 patients (251 men and 600 women) who had undergone either abdominal, orthopaedic or gynaecological surgery as out-patients were given the questionnaire. Five hundred and fifteen patients (166 men and 349 women), i.e. 61%, answered. Nineteen percent had had their operation performed in local or regional anaesthesia, 30% in a combination of general anaesthesia with local infiltration, the remaining patients were operated under general anaesthesia. Eighty to ninety percent were satisfied with the preoperative information, and 88% were satisfied with the anaesthesia. Sixty-nine percent had had either no pain or almost no pain within the first 24 hours after the operation. Six percent found it difficult to stay home. Sixteen percent needed some kind of medical contact. Ninety-two percent said they would prefer out-patient surgery again as opposed to hospitalization, were they to need another operation. In conclusion, we found that these types of out-patient operations were acceptable to most of our patients (92%). We recommend widespread use of local anaesthetics in combination with general anaesthesia in order to minimize postoperative pain and facilitate the effect of postoperative analgetics.

Ambulatory Surgical Procedures↗
PubMed1993

[Local joint treatment in chronic polyarthritis: intra-articular corticosteroids and radioactive isotopes].

Intrasynovial injection of corticosteroids is currently one of the routine measures in the treatment of patients with rheumatoid arthritis. Crystalline corticosteroid suspensions have proved their value and are effective for approximately one to three weeks. One or two injections can control synovitis for prolonged periods of time. Special attention has to be given to impeccable technique of instillation. However, it must be kept in mind that, within the overall management of rheumatoid arthritis, the intra-articular injection of corticosteroids is a local, palliative and temporary measure. The intrasynovial instillation of radionuclides is used only in selected cases. Therapy of the knee joint is mainly performed with Yttrium-90, less frequently, the interphalangeal joints are treated with Erbium-169. Costs and radiation exposure are low, but a favourable result is only achieved in slightly more than 50 per cent of cases. This review provides a synopsis of the basic concepts and practical applications of intrasynovial corticosteroid and radioisotope injection therapy.

Administration, Topical↗
PubMed1993

[Suspected adult-onset Still's disease: unexpected manifestation of leprosy].

A 23-year old male from Sri Lanka was admitted to hospital with symmetrical inflammatory peripheral polyarthritis, fever of 39 degrees C and poly-lymphadenopathy. At first we suspected adult onset Still's disease. The histological findings from axillary lymph node biopsy strongly suggested the diagnosis of leprosy, for which we had had little evidence thus far. Typical skin lesions were absent, skin smears were negative and neurological symptoms only became obvious much later when fever and arthritis had subsided under anti-inflammatory treatment. At this time a right ulnar palsy developed, with atrophy of the interosseous muscles and thickening of the ulnar nerves at both medial epicondyles. Fite-stains of a sural nerve biopsy confirmed the diagnosis when mycobacteria were detected. Leprosy displays a clinico-pathological spectrum caused by variations in host resistance. A widely accepted classification is the five group system of Ridley and Jopling. At one extreme of this spectrum are patients with lepromatous or low resistance leprosy with numerous bacilli, and at the other those with high resistance or tuberculous leprosy where few or no bacilli are found. The numerous bacilli in the sural nerve biopsy classified the disease as lepromatous in our case. Of the various manifestations of the lepra reaction occurring in lepromatous leprosy, one is acute arthritis, but a more common one is erythema nodosum leprosum. Our patient's clinical presentation was interpreted to be a rheumatic manifestation of a type-2 reaction. This form of immunological response in leprosy is an immune complex syndrome and may mimic different rheumatic diseases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

The metaphase II arrest in mouse oocytes is controlled through microtubule-dependent destruction of cyclin B in the presence of CSF.

In unfertilized eggs from vertebrates, the cell cycle is arrested in metaphase of the second meiotic division (metaphase II) until fertilization or activation. Maintenance of the long-term meiotic metaphase arrest requires mechanisms preventing the destruction of the maturation promoting factor (MPF) and the migration of the chromosomes. In frog oocytes, arrest in metaphase II (M II) is achieved by cytostatic factor (CSF) that stabilizes MPF, a heterodimer formed of cdc2 kinase and cyclin. At the metaphase/anaphase transition, a rapid proteolysis of cyclin is associated with MPF inactivation. In Drosophila, oocytes are arrested in metaphase I (M I); however, only mechanical forces generated by the chiasmata seem to prevent chromosome separation. Thus, entirely different mechanisms may be involved in the meiotic arrests in various species. We report here that in mouse oocytes a CSF-like activity is involved in the M II arrest (as observed in hybrids composed of fragments of metaphase II-arrested oocytes and activated mitotic mouse oocytes) and that the high activity of MPF is maintained through a continuous equilibrium between cyclin B synthesis and degradation. In addition, the presence of an intact metaphase spindle is required for cyclin B degradation. Finally, MPF activity is preferentially associated with the spindle after bisection of the oocyte. Taken together, these observations suggest that the mechanism maintaining the metaphase arrest in mouse oocytes involves an equilibrium between cyclin synthesis and degradation, probably controlled by CSF, and which is also dependent upon the three-dimensional organization of the spindle.

Animals↗
PubMed1993

p-ANCA as a diagnostic marker in ulcerative colitis.

P-ANCA that do not react with myeloperoxidase (MPO) have been claimed to serve as a useful diagnostic marker in the differential diagnosis of inflammatory bowel disease (IBD). Therefore, in this study we determined the frequency of MPO-negative-p-ANCA in patients with inflammatory bowel disease and correlated the presence with intestinal and extra-intestinal disease manifestation. In 44 out of 65 (68%) sera from patients with ulcerative colitis (UC) but in only 14 of 66 (21%) with Crohn's disease (CD) MPO-negative-p-ANCA were detected whereby colonic involvement and extraintestinal manifestations seemed to be important. There was no correlation to therapy, activity, sex, age, extent and duration of disease. Moreover, the sera did not exhibit significant reactivity in ELISAs testing for Cathepsin G-, Lactoferrin-, Myeloperoxidase-, Elastase- or Proteinase 3- specificity.

Adult↗
PubMed1993

Calcific periarthritis of the finger verified by X-ray diffraction of apatite.

The authors describe a 24-year-old woman presenting with swelling and pain of several finger joints. Roentgenograms showed periarticular, calcific deposits at all locations of swelling. One such deposit revealed the presence of hydroxyapatite crystals on X-ray diffraction. After two injections of corticosteroids in and around one deposit its size and density diminished rapidly, whereas the uninjected corresponding site of the other hand showed no initial improvement; after two years no difference was discernible. Under systemic and topic NSAIDs, pain and swelling improved similarly in all joints. In conclusion, periarthritis of the fingers associated with radiopaque deposits responded favourably to NSAID therapy, while local corticosteroid injections showed no additional benefit.

Adult↗
PubMed1993

Immune cells mediate epinephrine secretion from bovine chromaffin cells in vitro.

Potential immunological influences on peripheral catecholamine secretion were investigated by measuring epinephrine secretion from chromaffin cells in vitro in response to cell-free conditioned media from mononuclear cells. Chromaffin cells were isolated from bovine adrenals whereas mononuclear cells were isolated from bovine spleen tissue or whole bovine blood. In secretion experiments epinephrine release and epinephrine remaining in cells was determined such that secretion was expressed as % of total cell content. After 90 minutes exposure to conditioned media, 22.8 +/- 1.1% of content was released compared to 1.7 +/- 0.2% with RPMI media. Secretion after filtration (< 3,000 MW cutoff) was 21.6 +/- 0.9% whereas after boiling and boiling in acid, secretion was 10.2 +/- 0.2 and 4.3 +/- 0.1% respectively. Dialysis (< 3,000 MW cutoff) reduced the 90 min conditioned media-stimulated epinephrine secretion from 22.5 +/- 3.8% to 2.3 +/- 0.3%. Neither atropine nor hexamethonium blockade altered the conditioned media-stimulated epinephrine secretion. These results suggest that mononuclear cells produce a low molecular weight substance--most likely a peptide--that contributes to the stimulation of epinephrine secretion.

Adrenal Glands↗
PubMed1993

Rhythm changes during resuscitation from ventricular fibrillation.

Defibrillation of patients with primary ventricular fibrillation (VF) results in a variety of rhythm changes. We analysed these changes in rhythm in 200 patients, using the American Heart Association's recommendation of two defibrillations prior to drug therapy. Sixty-three (31.5%) patients were immediate survivors with 38 (19%) being discharged from hospital alive. There was no difference between the age of immediate survivors (66.5 years, S.D. = 11.2) and non-survivors (68.3 years, S.D. = 13.7, P = 0.37). Immediate survivors were significantly more likely to be discharged alive from hospital if they were younger (70.0 years, S.D. 8.5 vs. 62.1 years, S.D. 15.8, P = 0.014). Increasing delays to the initiation of basic life support (CPR) and to defibrillation were associated with significantly less likelihood of cardioversion to sinus rhythm (P < 0.005 and P < 0.002, respectively). Those patients who stayed in VF were not more likely to be defibrillated into asystole or electro-mechanical dissociation. Seventeen percent (34) of patients were defibrillated to sinus rhythm after the first defibrillation and 14% (19) after the second, with similar hospital discharge rates (62% and 58%, respectively). Sixty percent (32) of patients in sinus rhythm, after two defibrillations, were discharged alive, compared to only 4% (6) of those patients not in sinus rhythm after two defibrillations. Our data provide new information on rhythm changes during resuscitation and supports the need for the earliest possible initiation of basic life support and defibrillation to improve survival from cardiac arrest due to ventricular fibrillation.

Age Factors↗
PubMed1993

COL4A5 splice site mutation and alpha 5(IV) collagen mRNA in Alport syndrome.

Mutations affecting the COL4A5 gene encoding the alpha 5 chain of type IV collagen, are involved in the pathogenesis of X-linked Alport syndrome. We used denaturing gradient gel electrophoresis (DGGE) to screen PCR amplified exons of COL4A5 for point mutations in a set of 18 Alport patients previously characterized by Southern blotting. One sequence variant was identified in the exon 38 region of a male Alport patient. Sequence analysis revealed a G to C transversion in the 5' intron splice donor site downstream from exon 38 (GT to CT). To determine the effect of the mutation on mRNA splicing, alpha 5(IV) cDNA was generated from total RNA of peripheral blood lymphocytes. Subsequent cDNA PCR yielded a product 81 base pairs shorter in the affected Alport patient, compared to normal controls. The absence of exon 38 from the alpha 5(IV) cDNA was confirmed by sequence analysis. The results demonstrated that the mutation leads to skipping of exon 38 in the processing of alpha 5(IV) pre-mRNA. The shortened transcript lacked 27 codons encoding a Gly-X-Y-repeat sequence with a preserved reading frame, enabling the translation of codons further downstream. Clinically, the patient presented with juvenile onset Alport syndrome, end-stage renal failure, and deafness. He had no ocular lesions. Typical ultrastructural changes of the glomerular basement membrane (GBM) were shown on electron microscopy. The patient developed anti-GBM antibodies after renal transplantation, however, renal function deteriorated only moderately.

Adult↗
PubMed1993

Insufficiency fractures of the sacrum. Twenty cases and review of the literature.

Over the past 10 years, 231 insufficiency fractures of the sacrum have been reported in the literature. These fractures, which are due to osteopenia, form a distinct subgroup of pathologic fractures. In 1.8% (n = 20) of the older-than-55-years female patients (total = 1,015) admitted to the authors' Rheumatology department between 1989 and 1991, a fracture of the sacrum was diagnosed. In all cases the diagnosis was confirmed with computed tomography. Frequency, age, sex, diagnosis, underlying diseases, and associated fractures of the 20 cases of insufficiency fractures of the sacrum are described and compared with those previously reported. Insufficiency sacral fracture as a cause of low-back pain in women older than 55 years of age is concluded to be a clinical entity.

Aged↗
PubMed1993

Arbitrarily primed polymerase chain reaction as a rapid method to differentiate crossed from independent Pseudomonas cepacia infections in cystic fibrosis patients.

We used DNA fingerprinting by the arbitrarily primed polymerase chain reaction (AP-PCR) technique for an epidemiological investigation of 23 Pseudomonas cepacia isolates obtained from 11 cystic fibrosis (CF) patients attending our CF center. This approach was compared with ribotyping, pulsed-field gel electrophoresis (PFGE), and conventional phenotypic typing. AP-PCR and ribotyping were identical in resolving power, since the two methods generated four different profiles and identified the same group of strains. Six patients on the one hand and four on the other harbored strains of the same genotype, thus raising the possibility of either patient-to-patient transmission or acquisition from a common hospital environmental source. PFGE results were in good agreement with those of the other two methods, but PFGE seems more discriminative since it generated a fifth profile for a single strain in a group of four. Our results show in vivo stability for the three methods during a period extending from 3 to 41 months. These genotypic techniques are particularly promising for clinical laboratories to help to clarify the epidemiology of P. cepacia in CF patients. The AP-PCR method constitutes an easier alternative to the well-established ribotyping method. AP-PCR provides the quickest results with minimal technical complexity. However, our results suggest that it is less discriminative than the labor-intensive PFGE method.

Base Sequence↗
PubMed1993

[Estimation with bacteriology of the evolution of nosocomial infections between 1989 and 1991 in an university hospital].

The bacteriological laboratory data base was studied with an original software (Bacterio) and an appropriate method ("doubles" and early samples are not taken in account) to estimate the nosocomial infections. The incidence rates for 100 hospitalizations at the University hospital of Nancy are 9.2, 8.2 et 8.2 for respectively 1989, 90 et 91. These values are corrected while taking into account a method's sensibility of 65%. The 1000 days of hospitalization's rates allow a better comparison between the medical departments. For the whole hospital, the results are respectively of 7.9, 7.2 and 7.5%. Even if the many bias described cannot always been checked, the method gives some evolutivity indicators which are very useful for the hygienists.

Cross Infection↗
PubMed1993

Multiple pathways for activation of MAP kinases.

p42/Mitogen activated protein kinase (MAPK) and MAP Kinase Kinase (MAPKK) activities are constitutively elevated in v-raf transformed NIH3T3 cells, which correlates with increased tyrosine phosphorylation of p42mapk protein. These activities can be further enhanced to a moderate extent by treatment of raf-transformed cells with either serum, tetradecanoyl phorbol acetate (TPA), or aluminium fluoride. A similar activation of MAPK is observed in a cell line (M17raf) coexpressing a dominant inhibitory ras mutant (N-17 ras) along with v-raf. However, in this cell line, both the serum and TPA stimulated response of MAPK activity is reduced compared to similarly treated raf-transformed cells, while aluminium fluoride is equally potent in all the cell lines tested. These studies indicate that in addition to c-Raf-1, serine/threonine kinase, which is an upstream activator of MAPK, other c-ras dependent as well as c-ras independent pathways also can contribute to MAPK activation.

3T3 Cells↗